US9364663B2 - Detector for electromagnetic fields - Google Patents
Detector for electromagnetic fields Download PDFInfo
- Publication number
- US9364663B2 US9364663B2 US14/697,062 US201514697062A US9364663B2 US 9364663 B2 US9364663 B2 US 9364663B2 US 201514697062 A US201514697062 A US 201514697062A US 9364663 B2 US9364663 B2 US 9364663B2
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- magnetic field
- imd
- detection unit
- field sensors
- control unit
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- 230000005672 electromagnetic field Effects 0.000 title description 11
- 238000001514 detection method Methods 0.000 claims abstract description 39
- 230000000638 stimulation Effects 0.000 claims abstract description 13
- 230000002123 temporal effect Effects 0.000 claims abstract description 8
- 239000007943 implant Substances 0.000 claims description 14
- 230000004044 response Effects 0.000 claims description 6
- 230000008859 change Effects 0.000 claims description 5
- 238000012544 monitoring process Methods 0.000 description 7
- 208000032366 Oversensing Diseases 0.000 description 6
- 238000005259 measurement Methods 0.000 description 6
- 238000000034 method Methods 0.000 description 6
- 239000003814 drug Substances 0.000 description 5
- 238000002595 magnetic resonance imaging Methods 0.000 description 5
- 235000014676 Phragmites communis Nutrition 0.000 description 4
- 230000000747 cardiac effect Effects 0.000 description 4
- 229940079593 drug Drugs 0.000 description 4
- 230000035939 shock Effects 0.000 description 4
- 239000003990 capacitor Substances 0.000 description 3
- 230000000694 effects Effects 0.000 description 3
- 230000003068 static effect Effects 0.000 description 3
- 230000004913 activation Effects 0.000 description 2
- 230000008901 benefit Effects 0.000 description 2
- 238000011156 evaluation Methods 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 230000033764 rhythmic process Effects 0.000 description 2
- 230000035945 sensitivity Effects 0.000 description 2
- 230000001629 suppression Effects 0.000 description 2
- 238000003325 tomography Methods 0.000 description 2
- 206010003119 arrhythmia Diseases 0.000 description 1
- 238000010438 heat treatment Methods 0.000 description 1
- 230000000004 hemodynamic effect Effects 0.000 description 1
- 238000002847 impedance measurement Methods 0.000 description 1
- 230000001939 inductive effect Effects 0.000 description 1
- 230000002045 lasting effect Effects 0.000 description 1
- 230000005415 magnetization Effects 0.000 description 1
- 239000003550 marker Substances 0.000 description 1
- 238000012806 monitoring device Methods 0.000 description 1
- 238000013421 nuclear magnetic resonance imaging Methods 0.000 description 1
- 230000000737 periodic effect Effects 0.000 description 1
- 230000002035 prolonged effect Effects 0.000 description 1
- 230000029058 respiratory gaseous exchange Effects 0.000 description 1
- 238000000926 separation method Methods 0.000 description 1
- 238000002633 shock therapy Methods 0.000 description 1
- 238000002560 therapeutic procedure Methods 0.000 description 1
- 238000004148 unit process Methods 0.000 description 1
- 230000002861 ventricular Effects 0.000 description 1
- 208000003663 ventricular fibrillation Diseases 0.000 description 1
Images
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/02—Details
- A61N1/08—Arrangements or circuits for monitoring, protecting, controlling or indicating
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/36—Applying electric currents by contact electrodes alternating or intermittent currents for stimulation
- A61N1/362—Heart stimulators
- A61N1/37—Monitoring; Protecting
- A61N1/3718—Monitoring of or protection against external electromagnetic fields or currents
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61N—ELECTROTHERAPY; MAGNETOTHERAPY; RADIATION THERAPY; ULTRASOUND THERAPY
- A61N1/00—Electrotherapy; Circuits therefor
- A61N1/18—Applying electric currents by contact electrodes
- A61N1/32—Applying electric currents by contact electrodes alternating or intermittent currents
- A61N1/38—Applying electric currents by contact electrodes alternating or intermittent currents for producing shock effects
- A61N1/39—Heart defibrillators
- A61N1/3925—Monitoring; Protecting
- A61N1/3931—Protecting, e.g. back-up systems
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
- G01R33/00—Arrangements or instruments for measuring magnetic variables
- G01R33/02—Measuring direction or magnitude of magnetic fields or magnetic flux
- G01R33/022—Measuring gradient
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
- G01R33/00—Arrangements or instruments for measuring magnetic variables
- G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
- G01R33/28—Details of apparatus provided for in groups G01R33/44 - G01R33/64
- G01R33/285—Invasive instruments, e.g. catheters or biopsy needles, specially adapted for tracking, guiding or visualization by NMR
-
- G—PHYSICS
- G01—MEASURING; TESTING
- G01R—MEASURING ELECTRIC VARIABLES; MEASURING MAGNETIC VARIABLES
- G01R33/00—Arrangements or instruments for measuring magnetic variables
- G01R33/20—Arrangements or instruments for measuring magnetic variables involving magnetic resonance
- G01R33/28—Details of apparatus provided for in groups G01R33/44 - G01R33/64
- G01R33/288—Provisions within MR facilities for enhancing safety during MR, e.g. reduction of the specific absorption rate [SAR], detection of ferromagnetic objects in the scanner room
Definitions
- Embodiments of the invention generally relate to a method for identifying electromagnetic fields with implantable medical devices, specifically electromagnetic fields that occur when using nuclear magnetic resonance imaging and tomography (e.g., MRI, MRT) devices.
- nuclear magnetic resonance imaging and tomography e.g., MRI, MRT
- MR magnetic resonance
- MRI magnetic resonance imaging
- MRT magnetic resonance tomography
- U.S. Pat. No. 6,522,920 to Silvian et al. entitled “System and Method of Protecting Transformer-Driven Switches from External Magnetic Fields”, describes a system for protecting the inductively actuated high-voltage switch of an ICD during shock delivery in a magnetic field.
- the system monitors whether a sufficient gate voltage is provided at the moment of the shock delivery. According to Silvian et al., the monitoring is assessed by means of an assessment of the secondary voltage of the inductive drivers.
- United States Patent Publication 20080071168 to Gauglitz et al., entitled “Systems and Methods for Sensing External Magnetic Fields in Implantable Medical Devices”, provides an impedance measuring unit and an RLC member for detection of a magnetic field and to perform the detection by determining the inductance in the RLC component.
- an additional or adapted impedance measuring unit is required for this purpose.
- U.S. Pat. No. 7,509,167 to Stessman entitled “MRI Detector for Implantable Medical Device”, describes the identification of a magnetic field by the measurement of the timings for the actuation of the high-voltage transformer of the primary side or alternatively by the measurement of peak currents during a charging cycle.
- the disadvantages of the described system of Stessman are that the measurement of the timings has to be very quick (us to ns), and that a direct current measurement may only be implemented with difficulty due to the necessary measuring resistor, which would lengthen the charge times for the high-voltage capacitor.
- One or more embodiments of the invention include an implantable medical device (IMD).
- IMD implantable medical device
- the IMD includes at least one power supply, one or more of at least one sensing device and at least one stimulation device, at least one control unit, at least one MR detection unit, and at least two magnetic field sensors.
- the at least one power supply may be connected directly or indirectly to one or more of the at least one sensing device, the at least one stimulation device, the at least one control unit, the at least one MR detection unit and the at least two magnetic field sensors.
- the at least one control unit may be connected directly or indirectly to one or more of the at least one sensing device and the at least one stimulation device.
- the at least one control unit may be connected directly or indirectly to the at least one MR detection unit and to the at least one magnetic field sensor.
- the at least two magnetic field sensors may be arranged spatially separately from one another.
- the at least one MR detection unit may determine a spatial and/or temporal gradient of magnetic field strengths, wherein the magnetic field strengths are detected by the at least two magnetic field sensors and transmitted to the at least one MR detection unit.
- the at least one MR detection unit may detect an MR field and transmit an MR signal to the at least one control unit if either
- the gradient may indicate a change of a magnetic field in space or in time
- the detection with the at least two magnetic field sensors provided in the IMD may be determined via a variation of the measured magnetic field strengths over time, wherein the at least two magnetic field sensors are arranged rigidly in the respective IMD or in an electrode line.
- the term MR field includes the electromagnetic field of an MR device.
- a static magnetic field of an MR or MRI device is used, wherein the static magnetic field is particularly strong.
- each magnetic field sensor of the at least two magnetic field sensors may include a GMR sensor, a Hall sensor, a reed switch, a MagFET, or any combination thereof, or any another magnetic field sensor within the field of the invention.
- the at least one control unit may change into a predetermined operating mode in response to the MR signal of the at least one MR detection unit.
- the predetermined operating mode may be an MR-safe state or an MR mode.
- the IMD may include an implantable pacemaker and/or a defibrillator/cardioverter (ICD), or may include a cardiac resynchronization IMD with an ICD and/or pacemaker.
- ICD defibrillator/cardioverter
- the IMD may include a neurostimulator or a drug pump.
- an MR-safe state may include a suppression of delivery of high-voltage shocks and/or provision of alternative IMD modes.
- an MR-safe state may include temporary switch-off of the IMD function, such as suppression of the delivery of IMD stimulations, or may include the switchover into an asynchronous stimulation mode, such as delivery of IMD stimulations without consideration and/or detection of rhythms naturally produced naturally in a body.
- a decision regarding a suitable MR-safe state may be made either when programming the IMD, or automatically when programming the IMD, or automatically during the detection of an MR field, or automatically at predetermined moments in time, or with certain events or patient states.
- the IMD may be switched into an MR-safe state (MR mode) by programming or by remote programming.
- the predetermined operating mode includes parameters that may be predetermined in accordance with one or more of the magnetic field strengths determined by the at least one MR detection unit, the temporal gradient fields and/or spatial gradient fields.
- the at least one MR detection unit may evaluate the gradient and absolute value of the detected magnetic field strengths when the detected magnetic field strengths lie below the first predetermined threshold value.
- the at least two magnetic field sensors may be arranged within the IMD or at least one of the magnetic field sensors may be arranged within the IMD and at least one further magnetic field sensor may be arranged in an electrode line connected to the IMD.
- an electrode line may be one or more of a line that applies electronic pulses and a sensor line.
- the respective sensor may be connected electronically, optically or optoelectronically to the IMD.
- the electrode line may be one or more of a hollow line to apply drugs and a sensor line.
- the at least one MR detection unit may form a signed difference between the at least two magnetic field sensors, and may use different first predetermined threshold values and/or second predetermined threshold values and/or first predetermined range of threshold values, depending on the sign, to detect the MR field.
- the minimum distance between the at least two magnetic field sensors is selected in accordance with a resolution of the at least two magnetic field sensors, such that the resolution is sufficient to distinguish between a local magnetic field and a widely distributed MR field with reference to the spatial gradients.
- a local magnetic field may include magnetic fields of permanent magnets or electromagnets as are present in a patient environment (for example in the form of loudspeakers or simple permanent magnets).
- the widely distributed MR fields differ from the local fields by their size.
- the magnetic fields may thus extend about 100-150 cm beyond the MR device with significantly measurable field strength of more than 2 mT, wherein 2 mT is a response threshold of the reed switch in conventional cardiac pacemakers.
- 2 mT is a response threshold of the reed switch in conventional cardiac pacemakers.
- typical magnetic fields to be expected in the patient environment achieve a propagation of a few centimeters within such a field strength.
- the MR signal may be transmitted to the at least one control unit and the at least one control unit may cause at least one predetermined automatic switchover of at least one implant setting of the IMD.
- the IMD may include one or more of at least one elongate electrode line and at least one sensor line.
- the at least one MR detection unit may identify an MR-typical journey of an IMD on a patient bed, based on one or more of a change over time of the measured values of the at least two magnetic field sensors and a difference between the measured values of the at least two magnetic field sensors.
- an MR-typical journey may include the entry or the exit of the patient bed into or out of the MR device or MRI device, with a patient having an IMD.
- the patient may be brought at speed into or out of a scanning position of the respective MR device, thus enabling determination of a change in the magnetic field strengths.
- predetermined or predeterminable parameters and/or threshold values and/or settings may be set, changed or predetermined, or any combination thereof, via one or more of a local programming device and remote programming.
- “remote programming” may include the programming of an IMD, wherein the IMD and a programming unit or a programming end may be spatially separated from one another, such that near-field telemetry (for example ⁇ 10 m) typically present is not sufficient alone to bridge the spatial separation.
- near-field telemetry for example ⁇ 10 m
- a switch-on of the MR-safe sate or when the MR-safe state has been switched on may be transmitted using telemetric remote monitoring, such as a home monitoring system.
- a signal or information is sent directly or via at least one intermediate device, for example a patient device, to a central unit, wherein the central unit processes the information or the signal or forwards it on where necessary.
- the information or the signal may be sent or transmitted at a later moment in time, for example as soon as there is a connection to the central unit or when such a connection may be produced.
- telemetric remote monitoring may include wherein information or signals may be transmitted from an IMD to a spatially distanced unit in order to enable a monitoring of the patient, even without a doctor's visit or hospitalization, for example, in that data may be transmitted from the IMD via a service center to a responsible doctor. In one or more embodiments, data may also be transmitted via the service center to the IMD.
- One or more embodiments of the invention may include a combination of methods for detecting electromagnetic fields, especially MR fields, and in combination with different responses to electromagnetic fields, especially MR fields.
- further detection methods may include one or more of:
- indicators may include methods and/or devices that determine whether electromagnetic interference fields are present.
- At least one embodiment of the invention may include other responses as further responses to detected electromagnetic fields, especially MR fields, such as, but not limited to, one or more of
- One or more embodiments of the invention may include a position sensor to check plausibility, and to check if positive identification of MR is only given when the position sensor signals a prone posture and/or another presettable posture.
- At least one embodiment of the invention may include the combination of the position sensor with the identification of an MR-typical journey of an IMD on the patient bed, wherein such a combination provides a particularly high sensitivity for the identification of MR fields of MR devices.
- the position sensor may be self-calibrating, wherein the calibration takes place under presettable marginal conditions, such as, but not limited to, one or more of time of day, heart rate, breathing rate, hemodynamic parameters, and activity (such as using a motion sensor).
- presettable marginal conditions such as, but not limited to, one or more of time of day, heart rate, breathing rate, hemodynamic parameters, and activity (such as using a motion sensor).
- FIG. 1 shows a schematic illustration of a course of an MR examination
- FIG. 2 shows a schematic illustration of a course of an MR BO field
- FIG. 3 shows a schematic illustration of an oversensing in MRT
- FIG. 4 shows a schematic illustration of an IMD with a two-magnetic field sensor system; according to one or more embodiments of the invention.
- FIG. 1 shows a schematic illustration of a course of a typical MR examination with an MR-compatible ICD.
- an ICD patient 100
- the ICD is switched off ( 110 ) in order to rule out an inadequate shock delivery during the MR scan by oversensing caused by the electromagnetic alternating fields acting on the electrode line.
- the MRT examination may be carried out by a radiologist after a temporal delay lasting from hours to days ( 120 ). After a further delay, the patient may again be treated by the cardiologist ( 130 ) and the ICD may be switched back on.
- the patient is without the protection of the implanted defibrillator and may be without rhythm monitoring.
- the remaining residual risk for example, which may be measured in proportion to the benefit of the MRT examination, is generally accepted.
- FIG. 2 shows a schematic illustration of a course of an MR BO field, and the problem with using an individual magnetic field sensor for MRT identification.
- the field strength distribution of the BO field of an MR device beyond the scanner is plotted by way of example ( 200 ).
- the magnetic field strengths may fall to approximately 5 mT at the head end of the patient, such that a magnetic field sensor in an implant in the vicinity of the head cannot perceive any MR-typical magnetic field strengths, and thus does not perform an automatic MR switchover.
- the implant would generally be located at a corresponding distance from the magnet of the MR device.
- the MR-typical magnetic field distribution differs considerably in terms of its “size” from that of a “normal” magnetic field source to be expected in the patient environment, for example a magnet in a programmer head.
- the field strengths above 2 mT may achieve a propagation of a few centimeters (typically ⁇ 10 cm).
- FIG. 3 shows a schematic illustration of an oversensing in MRT, wherein a measurement ( 300 ) is performed with an ICD system in a position of a patient with the feet in the isocenter and an implant in a chest region ( 210 ) of the patient (as shown in FIG. 2 ).
- an oversensing ( 310 , 320 ) is distinct in the ventricular sensing channels, which may lead to, in using an undeactivated ICD, to an inadequate shock therapy.
- Such oversensing is shown in the marker channel at fast right-ventricular detection markers ( 311 ), which are perceived by the implant following the distinct MR interference ( 312 ) above a threshold value. If the number of fast detection markers ( 311 ) exceeds a programmable limit value, an ICD may inadequately introduce an antitachycardia therapy.
- the magnetic field to be measured at the implant is only approximately 30 mT.
- FIG. 4 shows an IMD system with two magnetic field sensors, according to one or more embodiments of the invention.
- implantable medical device such as a cardiac pacemaker
- the implant may be connected to an electrode line ( 420 ), which senses and stimulates the heart via a distal dipole ( 430 ).
- the electrode line ( 420 ) includes a further magnetic field sensor ( 440 ), of which the measured values may be queried by the IMD.
- the second magnetic field sensor ( 440 ) when the first magnetic field sensor ( 410 ) senses a magnetic field above a threshold, the second magnetic field sensor ( 440 ) is queried, and an MRT switchover may then occur if the second magnetic field sensor ( 440 ) also indicates a magnetic field above the threshold.
- the threshold of the second magnetic field sensor ( 440 ) may be derived from a measured magnetic field of the first magnetic field sensor ( 410 ), and magnetic field propagations to be expected with MRT are set accordingly.
- a reliable distinction between local magnetic fields, such as patient magnets, or MR-typical magnetic fields beyond the scanner may be made.
- the evaluation of the second magnetic field sensor ( 440 ) may be omitted.
- the second magnetic field sensor ( 440 ) may be integrated in the electrode line, such as using one or more of a reed switch, a GMR sensor or the like, and the second magnetic field sensor ( 440 ) may function with a fixed threshold (for example 5 mT).
- the MR environment may then be confirmed (for example a field >1 mT) or rejected (for example a field ⁇ 1 mT) upon activation of the electrode sensor, such as the second magnetic field sensor ( 440 ) integrated in the electrode line, via the implant sensor, such as the first magnetic field sensor ( 410 ).
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Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US14/697,062 US9364663B2 (en) | 2014-06-05 | 2015-04-27 | Detector for electromagnetic fields |
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US201462007953P | 2014-06-05 | 2014-06-05 | |
| US14/697,062 US9364663B2 (en) | 2014-06-05 | 2015-04-27 | Detector for electromagnetic fields |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| US20150352354A1 US20150352354A1 (en) | 2015-12-10 |
| US9364663B2 true US9364663B2 (en) | 2016-06-14 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| US14/697,062 Expired - Fee Related US9364663B2 (en) | 2014-06-05 | 2015-04-27 | Detector for electromagnetic fields |
Country Status (2)
| Country | Link |
|---|---|
| US (1) | US9364663B2 (de) |
| EP (1) | EP2952224A1 (de) |
Cited By (6)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US20190039466A1 (en) * | 2017-08-07 | 2019-02-07 | Hyundai Motor Company | Charging control method, electric vehicle and charging apparatus using the same |
| US10641858B2 (en) * | 2017-04-06 | 2020-05-05 | Bilkent University | Spatiotemporal magnetic field monitoring with hall effect sensors during the MRI scan |
| WO2021165008A1 (en) | 2020-02-21 | 2021-08-26 | Biotronik Se & Co. Kg | Implantable medical device configured for detecting a presence of an mri device |
| WO2021224087A1 (en) | 2020-05-06 | 2021-11-11 | Biotronik Se & Co. Kg | Medical system for performing a therapeutic function on a patient |
| WO2022008215A1 (en) | 2020-07-08 | 2022-01-13 | Biotronik Se & Co. Kg | Implantable medical device operative in the presence of an mri device |
| US11844599B2 (en) | 2019-11-25 | 2023-12-19 | GE Precision Healthcare LLC | Scanning control system and method for magnetic resonance imaging system |
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| Publication number | Priority date | Publication date | Assignee | Title |
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| CA2941431C (en) * | 2014-03-28 | 2018-01-09 | Aetonix Systems | Simple video communication platform |
| US10652504B2 (en) | 2014-03-28 | 2020-05-12 | Aetonix Systems | Simple video communication platform |
| US10286209B2 (en) | 2016-04-29 | 2019-05-14 | Medtronic, Inc. | Methods and implantable medical devices for automatic entry to an exposure mode of operation upon exposure to a magnetic disturbance |
| US20200012008A1 (en) * | 2018-07-08 | 2020-01-09 | Wayne State University | Parity-time (pt)-symmetric wireless telemetric sensors and systems |
| US20220111201A1 (en) * | 2020-10-08 | 2022-04-14 | Inspire Medical Systems, Inc. | Identifying a presence-absence state of a magnetic resonance imaging system |
| WO2024193999A1 (en) * | 2023-03-21 | 2024-09-26 | Biotronik Se & Co. Kg | Mode adjustment arrangement |
| AU2024354654A1 (en) * | 2023-10-06 | 2026-04-02 | Axonics, Inc. | Mri detection system for implantable medical device |
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2015
- 2015-04-22 EP EP15164573.6A patent/EP2952224A1/de not_active Withdrawn
- 2015-04-27 US US14/697,062 patent/US9364663B2/en not_active Expired - Fee Related
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Cited By (8)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US10641858B2 (en) * | 2017-04-06 | 2020-05-05 | Bilkent University | Spatiotemporal magnetic field monitoring with hall effect sensors during the MRI scan |
| US20190039466A1 (en) * | 2017-08-07 | 2019-02-07 | Hyundai Motor Company | Charging control method, electric vehicle and charging apparatus using the same |
| US11844599B2 (en) | 2019-11-25 | 2023-12-19 | GE Precision Healthcare LLC | Scanning control system and method for magnetic resonance imaging system |
| US12089923B2 (en) | 2019-11-25 | 2024-09-17 | GE Precision Healthcare LLC | Scanning control system and method for magnetic resonance imaging system |
| WO2021165008A1 (en) | 2020-02-21 | 2021-08-26 | Biotronik Se & Co. Kg | Implantable medical device configured for detecting a presence of an mri device |
| WO2021224087A1 (en) | 2020-05-06 | 2021-11-11 | Biotronik Se & Co. Kg | Medical system for performing a therapeutic function on a patient |
| US12508429B2 (en) | 2020-05-06 | 2025-12-30 | Biotronik Se & Co. Kg | Medical system for performing a therapeutic function on a patient |
| WO2022008215A1 (en) | 2020-07-08 | 2022-01-13 | Biotronik Se & Co. Kg | Implantable medical device operative in the presence of an mri device |
Also Published As
| Publication number | Publication date |
|---|---|
| EP2952224A1 (de) | 2015-12-09 |
| US20150352354A1 (en) | 2015-12-10 |
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